A Statewide Assessment of

Obesity Prevention Needs and Readiness among Early Childhood Education Sites

Theresa LeGros MA,1 Laurel Jacobs DrPH MPH,1 Kathryn Orzech PhD,1 Noelle Veilleux RDN2

1The University of Arizona, Department of Nutritional Sciences 2Arizona Department of Health Services, Bureau of Nutrition and Physical Activity

BackgroundThe USDA’s Supplemental Nutrition Assistance Program-Education

(SNAP-Ed) promotes obesity prevention programming in Early

Childhood Education centers (ECEs). In Arizona, SNAP-Ed local

implementing agencies (“agencies”) support nutrition and physical

activity in ECEs with a combination of policy, systems, and

environmental (PSE) improvements and direct education. These efforts

align with the state’s Empower program,1 which offers discounted

licensing fees for ECEs that agree to implement wellness standards.

Conclusion

Objective

This statewide assessment

describes needs, barriers,

and opportunities related

to the nutrition and physical

activity policies and

procedures of Arizona’s

SNAP-Ed qualifying ECEs.

We assessed needs and readiness among Arizona’s SNAP-Ed qualifying ECEs using mixed methods:

ARIZONA DEPARTMENT OF HEALTH SERVICES

Empower ProgramSNAP-Ed Program

• Nutrition PSE Support

• Physical Activity PSE Support

• Direct Education

• Discounted Licensing Fees

• 6 Wellness Standards for

Nutrition & Physical ActivityObesity Prevention

in Arizona ECEs

OPPORTUNITIES

QUANTITATIVE DATA

We trained SNAP-Ed agencies

in 10 Arizona counties to use the

Go NAP SACC Child Nutrition

and Infant & Child Physical

Activity2 instruments to collect

information related to ECEs’

current practices and policies.

Descriptive statistics were used

to summarize data.

QUALITATIVE DATA

At the project close, we

collected written narrative

reports of agency experiences

with ECEs and held a debrief

with agency staff who

completed Go NAP SACCs.

Nvivo 10.0 software was used

for coding and theme analysis.

Go NAP SACC

Scores

Narrative

Reports &

Debrief

Data

Triangulation References

Results

1

2Ward D, Morris E, McWilliams C, Vaughn A, Erinosho T, Mazzuca S, Hanson P, Ammerman A, Neelon S, Sommers J, Ball S. (2014) Go NAP SACC: Nutrition and Physical

Activity Self-Assessment for Child Care, 2nd Edition. Center for Health Promotion and Disease Prevention and Department of Nutrition, University of North Carolina at

Chapel Hill. Available at: www.gonapsacc.org.

The USDA is an equal opportunity employer.

Empower Guidebook, Third Edition: Ten Ways to Empower Children to Live Healthy Lives, Standards for Empower Child Care Facilities in Arizona. Available at:

http://azdhs.gov/documents/prevention/nutrition-physical-activity/empower/resources-policies/empower-guidebook.pdf.

38%

27%

27%8%

Competing demands on ECE

ECE staff turnover or closings

Agency staff turnover or lack of capacity

Cannot systematically track ECEs

“The [ECE] is already highly inspected, required to

meet multiple standards and submit numerous

detailed reports… they are NAC accredited, ADHS

licensed, EMPOWER registered, and a designated

First Things First site.”

Agencies collected Go NAP SACC assessments from 40 ECEs in 10

counties. Triangulated data revealed these emergent themes:

• Greater need for physical activity vs. nutrition support. Lower physical activity scores

(Figures 1a,b) were corroborated by narrative reports (Figure 2).

• Recognized need for family education and professional development of ECE staff

(Figures 1,2). Narratives revealed that ECEs sought training specific to Empower

standards but that barriers sometimes inhibited progress (Figure 3).

• Unrecognized need for improved policy. The need to improve written ECE policies

identified in Figures 1a,b was not addressed in narrative reports.

53%

22%

14%

4%7%Education & professional

development

Improvements to PA

practices/environments

Improvements to nutrition

practices/environments

Establishing or improving

written policies

Unspecified

FIGURE 2. REFERENCES TO ECE NEEDS BY SNAP-ED AGENCIES,

N=77

“Administrators were familiar with

Empower, solely based on the licensure

discount, but not a single individual was

specifically familiar with the standards.”

This study revealed a need to improve written policies, family education, and professional staff

development at ECEs. When ECE time and resources are limited, Arizona’s SNAP-Ed agencies may wish

to prioritize physical activity programming and Empower Trainings.

MIXING METHODS

After all analyses were completed, quantitative and qualitative findings were triangulated to identify ECEs’

wellness-related needs, barriers, and opportunities.

FIGURE 3. REPORTED BARRIERS TO COLLABORATION BETWEEN

ECES AND SNAP-ED AGENCIES, N=48

3.4

3.5

3.7

3.5

3.5

3.6

3.2

2.8

0 1 2 3 4

All Sections

Foods Provided

Beverages Provided

Feeding Environment

Feeding Practices

Menus & Variety

Ed & Prof Development

Policy

FIGURE 1A. MEAN GO NAP SACC

CHILD NUTRITION SCORES, N=34

3.3

2.9

3.3

3.5

3.3

3

0 1 2 3 4

All Sections

Time Provided

Indoor Play Environment

Teacher Practices

Ed & Prof Development

Policy

FIGURE 1B. MEAN GO NAP SACC

INFANT & CHILD PHYSICAL ACTIVITY

SCORES, N=34

1 = weakest practice, 4 = best practice

RED: < 3.0 ORANGE: 3.1-3.4 GREEN: > 3.5